Inspection on 10/11/08 for Denehurst Care Home

This inspection was carried out on 10th November 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Denehurst Care Home Merrington Lane Dean Bank Ferryhill Durham DL17 8NL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sam Doku     Date: 1 0 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Denehurst Care Home Merrington Lane Dean Bank Ferryhill Durham DL17 8NL 01740655314 01740650771 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Charlotte Marriner Type of registration: Number of places registered: Doson Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability terminally ill Additional conditions: The maximum number of service users who can be accommodated is: 37 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 37 Physical Disability, Code PD, maximum number of places 5 Date of last inspection Brief description of the care home Denehurst is a registered care home for older people ad also provides nursing care. In addition the home provides care for people with physical disabilities over the age of fifty-five. Denehurst is a large Victorian house that has been extended and adapted to Care Homes for Older People Page 4 of 26 0 5 0 Over 65 37 0 10 Brief description of the care home use as a care home. The home is located in an attractive grounds close to the centre of Ferrihill in Co. Durham. The accommodation is over two floors, with lounge and dinning rooms on each floor and a passenger lift to access both floors. There are 35 single bedrooms and 23 of these have en-suite toilet facilities. There is one double room but it is currently being used as a single room. The current fees charged are between 417 pounds and 608.98 pounds per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating of this service is 2 Star. This means the people who use the service experience good quality outcomes.The inspection was unannounced and commenced on 10 November 2008 and completed on the same day. Before the visit the inspector looked at: Information we have received since the last inspection visit on 10 January 2007. How the service dealt with any complaints and concerns since the last inspection. Any changes to how the home is run. The providers view of how well they care for people, as highlighted in the details provided in the Annual Quality Assurance Assessment (AQAA). During the visit the inspector did the following: Talked to the people who use the Care Homes for Older People Page 6 of 26 service, the manager and the care staff. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff have the knowledge, skills and training to meet the needs of the people they care for. Looked around the home to make sure it is safe and secure. Checked what improvements have been made since the last inspection. The inspector told the manager what he found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The company provides good information about the home, including invitation for prospective residents to visit the home, which enable them to make informed decisions about whether to live there. However, some of the written information need to be updated to reflect the current owners policies. Assessments are carried out for all new residents to make sure that the home has the necessary skills and facilities to meet their needs and to promote their health and welfare. Evidence: Residents confirmed that the staff supplied them with information about the home when they were looking for a place. Information about the home is also available in the reception area for residents and visitors to see. The manager is currently reviewing some of these information so that they are in line with the current owners policies. Care Homes for Older People Page 10 of 26 Evidence: The service user guide and the statement of purpose are being reviewed and rewritten to take account of the new company that owns the home. The manager and the staff confirmed that it is the policy of the home to invite prospective residents to the home and to use that opportunity to meet with the staff and the residents. Two residents confirmed that this is a regular occurance and that they often see people looking around and being introduced to them. One resident said that she and her daughter came to look at the home and they found the experience extremely helpful. The residents and their relatives are encouraged to be actively involved in the admission process and to make it a positive experience. It is the homes policy to receive an assessment from a social worker or a nurse assessor before admission is arranged. The home also carries out their own assessment before confirming a place. A selected number of files were examined and there was evidence of social worker assessments and also of the homes assessments. The manager stated that these assessments are used to devise the care plans for the residents when they first come into the home. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of the residents are met, and care plans have been put in place to help staff address their needs. However, some of the care plans lack details and would need to be more specific to reflect the specific care needs that individuals may require. The residents are treated with dignity and their right to privacy is upheld. Evidence: Residents confirmed that they have access to healthcare facilities including GP support and other healthcare professionals. Residents gave examples of how the nursing staff regularly arrange for GP visits for them. The residents files provide details of the healthcare support that each individual resident gets. The care notes show entries of visits to or from healthcare professionals, including district nurses, psychiatrist, optician, chiropodist, dentist, occupational therapist and dietician. The care plans are well written and provide good information for staff to follow when Care Homes for Older People Page 12 of 26 Evidence: providig specific care tasks. Of the four care plans that were examined, one stands out as a good example of the good care and attention that residents receive. The care plan provided detials of how staff should support the lady in question and also what staff should do to maintain good circulation and exercise while she is confined to bed. However, some of the care plans are very general and do not provide the same level of details that others have. Care plans relating to peoples psychological needs should be more specific so that staff would know exactly what is expected of them when carrying out that task. The home has policies on the storage and administration of medicines. Some of these policies are currently being reviewed and re-written to reflect the policies of the current owner company. The manager confirmed that the nursing staff who are responsible for the administration of medicines have received up to date training in safe handling of medicines and follow the homes medication policies. A random check of the medicines administration system was undertaken by the inspector. There were no discrepancies noted, and the administration sheets have been signed and dated as required. The staff were noted to relate very well with the residents and there was obvious respect between the staff and the residents. Relatives and residents confirmed that the staff treat people with respect and dignity. The staff were polite, courteous, friendly and professional in the way they interracted with the residents. Staff were also noted to respect the privacy of the residents. Staff were observed to knock on bedroom doors before making entry. In one case, a carer was observed to ask a resident in the lounge whether it was alright to go into her room. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides activities that are enjoyed by the residents. Furthermore, families and friends are encouraged to contribute to the residents sense of wellbeing by being supported and encouraged to visit regularly. The residents are provided with good variety of wholesome and nutritious meals, which promotes their health and wellbeing Evidence: There are two dinning rooms in the home, one on each floor. These are pleasantly decorated and furnished to a good standard. The inspector had his lunch with the residents on the first floor. The tables were appropriately set and residents had their meals in a pleasant and comfortable environment. The residents were given plenty of time to enjoy their lunch and people who require help from staff with the meals were given that support in ways that preserved their dignity. Residents said they like the food and that there is always plenty to eat. They described the food as excellent and they commented favourably on the choice of menus that they get. Care Homes for Older People Page 14 of 26 Evidence: Smoking is only permitted outside of the home. Two residents commented that it would be helpful if they could have a place in the grounds that is sheltered so that they dont get wet when it rains or snows. The inspector discussed this with the manager and asked her to speak with the people who smoke and to find the most apprppriate arrangement that would suit everyone. The home has an activities coordinator who works on a part-time basis. The residents described the activities that are organised for them. They include bingo, card games, sing along, films and outings. They commented that they always look forward to organised activites and praised the activities coordinator for her commitment. At the time of the inspection, a small group of residents were enagaged in card games and a game of dominoes. The manager also informed the inspector that transport arrangements have been made to provide the opportunity for outdoor activities and outings for groups of six people at a time, including wheelchar users. Residents confirmed that they get up and go to bed when they want. One resident said I speak for everyone here, no one is made to get up if they dont want to. Residents said they are provided with cups of tea when they first get up in the morning. One resident also stated that sometimes she prefers to have her breakfast in bed and staff would make arrangements for this to happen. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives have information about how to make a complaint thus promoting the residents right to express their views about the service. Staff are aware of safeguarding adults procedures and have received suitable training which safeguard the residents from any form of abuse. Furthermore, there are suitable arrangements in place for accounting for the residents persoanal allowance. Evidence: The home has a complaints procedure and a copy of this is posted in the reception area for residents and visitors to see. The contact details of the Commission need to be updated to show the details of the local office of the Commission for Social Care Inspections. The inspector spoke with residents and relatives about the complaints procedure. Residents and relatives said they are aware of the procedure and feel confident about raising any concerns with the manager if they were unhappy about anything. Two staff members were also spoken with about the homes complaints procedure. Staff showed good knowledge and understanding of the complaints policy and procedure, and knew how to support residents if they wish to make a complaint. The manager confirmed that all staff have had training in safeguarding adults and Care Homes for Older People Page 16 of 26 Evidence: arrangements are being made to provide a refresher training to some of the staff. Staff who were spoken with were familiar with the homes policy on safeguarding vulnerable people and showed good understanding of safeguarding issues. The home has a good system in place for accounting for the residents personal allowance. Receipts are available for purchases made on the residents behalf. A random check of two accounts showed no discrepancy in the amount of monies held for the individuals. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides safe, secure, clean, warm and a pleasant environment for the residents to live in. Evidence: The home is clean and maintained to a good standard. Individual bedrooms that were visited were clean, appropriately furnished and maintained to a good standard. People have been encouraged to bring into the home their personal items such as pictures, photographs and small items of furniture to furnish their rooms with. As a result, bedrooms look homely and reflect individual tastes and preferences. All radiators have protective coverings and windows have restrictors on to stop intruders and to ensure the safety of the residents. The communal areas were clean and pleasantly furnished. People who were visiting the home stated that the home is always clean and has never had bad odour. The kitchen was well ordered and clean. The kitchen staff have maintained good hygiene standards. The maintenance man has a record of all the work that he does in the home to keep it in a good state of repair. Care Homes for Older People Page 18 of 26 Evidence: There are written policies covering all aspects of the running of the home, including health and safety. Some of these policies are in the process of being re-written to reflect the new owner companys official policies Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing numbers are satisfactory and promote the safety and welfare of the residents. The home adheres to good recruitment practices, which safeguards the welfare of the residents. Evidence: Examination of past rotas show that the home employs sufficient number of staff to meet the needs of the residents. There is a registered nurse on duty at all times including night duties. Staff were spoken to about the staffing levels in the home. They all said that the staffing levels are always adequate. One staff member indicated that on the whole the manager provides good staffing ratios but there are few ocassions when the staffing level reduces, especially during holiday time, but she stressed that the reduced numbers are not significant enough to affect the quality of the service and the care that they provide. The manager confirmed that the staff have received training in moving and handling, first aid, protection of vulnerable adults, fire safety, food hygiene and health and safety training. The nursing staff continue to receive refresher training to update them on nursing practices. Staff records show the training that they have received. Care Homes for Older People Page 20 of 26 Evidence: Four staff files were examined to check on the recruitment process by the manager. The files show that the home has been following good recruitment procedures. All the files contain completed job applications, copy of job description, appropriate references, evidence of CRB checks and record of induction and training. Information in the AQAA shows that fifteen care staff have NVQ Level II or above. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a qualified and experienced person, and runs the home for the benefit of the residents. The home has suitable arrangements in place to provide supervision for the staff. This promotes the quality of the service that the residents receive. The safety and welfare of residents is protected by the regular servicing of equipments and safety arrangements that are in place. Evidence: The registered manager has a long experience of managing a residential care home. Staff, residents and relatives commented on her ability as a manager. Staff stated that she is approachable and and always availble to advice them on any issues or problems that they may have. Staff said the manager is supportive of them and also of the residents. There are suitable arrangements for staff to receive one-to-one supervision. Care Homes for Older People Page 22 of 26 Evidence: Staff records show that the manager and her senior staff have provided individual supervision to staff on regular basis. Staff commented that they find the supervision sessions useful. The previous companys policies and procedures are currently being replaced with the ones that belong to the new owner company. Meanwhile, the staff are using these policies effectively. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). There is evidence that staff adhere to the policies as set by the company. Staff have received training in fire safety, COSHH, first aid, food hygiene and infection control. Servicing and maintenance records show that all portable appliances have been tested. A record is maintained of regular water temperature in bedrooms, toilets and bathrooms. Regular servicing of fire equipment, passenger lift, bath lifts and hoists, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. The homes fire risk assessment is up to date. Records examined indicate that fire precautions relating to weekly fire alarm testing and record of inspection takes place. There are records in the home indicating fire drills and fire instructions with staff. The manager confirmed that all staff have received up to date fire safety training. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 The home need to have a clear policy on smoking so that all the residents understand why it is not permitted to smoke in the home. The Complaints procedure should be updated to reflect the current details of the local offices of the Commission for Social Care Inspections. 2 16 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!